Abstract
We report a rare case of internal carotid artery agenesis with stenosed intercavernous anastomosis. A 59-year-old male patient presented with a new infarction in the left basal ganglia. Magnetic resonance angiography and cerebral angiography showed that the right internal carotid artery disappeared from the origin to the foramen lacerum segment, and there was an anastomotic artery with severe stenosis passed through the floor of the sella and in front of the cavernous sinus. The right A1 segment of the anterior cerebral artery was absent and A2 segment was supplied by the normal contralateral internal carotid artery via the anterior communicating artery.
Highlights
Occlusion of the internal carotid artery (ICA) due to atherosclerosis is common, but ICA agenesis is rare, in which the blood supply of the ipsilateral brain is always compensated by the contralateral ICA and vertebrobasilar system via the circle of Willis
The patient was admitted to the hospital, and a magnetic resonance angiography (MRA) examination showed that the right ICA disappeared from the origin to the foramen lacerum segment, the carotid canal was absent (Fig. 1C), while there was an intercavernous anastomotic vessel with stenosis connected bilateral ICAs which passed through the floor of the sella and in front of the cavernous sinus (Fig. 1D)
Several blood flow compensatory mechanisms may exist after unilateral ICA agenesis[1]
Summary
Occlusion of the internal carotid artery (ICA) due to atherosclerosis is common, but ICA agenesis is rare, in which the blood supply of the ipsilateral brain is always compensated by the contralateral ICA and vertebrobasilar system via the circle of Willis. We report a case of ICA agenesis with intercavernous anastomosis
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